Page 1658 - Saunders Comprehensive Review For NCLEX-RN

different things. First, you must know that a bronchodilator is always given before a
glucocorticoid. This would allow you to eliminate options 3 and 4, because you
would not alternate the medications. To select between the remaining option and the
correct option, you must know that salmeterol is a bronchodilator, whereas
beclomethasone is a glucocorticoid.
Level of Cognitive Ability: Applying
Client Needs: Physiological Integrity
Integrated Process: Nursing Process—Implementation
Content Area: Pharmacology: Respiratory Medications: Restrictive Airway Disease
Agents
Health Problem: N/A
Priority Concepts: Gas Exchange; Safety
Reference: Skidmore-Roth (2017), pp. 124-125.

595. Answer: 1, 2, 3, 5

Rationale: Rifabutin may be prescribed for a client with active MAC disease and
tuberculosis. It inhibits mycobacterial DNA-dependent RNA polymerase and
suppresses protein synthesis. Side and adverse effects include rash, gastrointestinal
disturbances, neutropenia (low neutrophil count), red-orange–colored body
secretions, uveitis (blurred vision and eye pain), myositis, arthralgia, hepatitis, chest
pain with dyspnea, and flu-like syndrome. Vitamin B deficiency and numbness and
6
tingling in the extremities are associated with the use of isoniazid.
Test-Taking Strategy: Focus on the subject, side and adverse effects of rifabutin.
Specific knowledge is needed to answer correctly. Remember that hepatitis, flu-like
syndrome, neutropenia, and uveitis can occur.
Level of Cognitive Ability: Analyzing
Client Needs: Physiological Integrity
Integrated Process: Nursing Process—Assessment
Content Area: Pharmacology: Respiratory Medications: Tuberculosis Medications
Health Problem: Adult Health: Respiratory: Tuberculosis
Priority Concepts: Clinical Judgment; Safety
Reference: Ignatavicius, Workman, Rebar (2018), p. 608.

596. Answer: 1

Rationale: Theophylline is a methylxanthine bronchodilator. The nurse teaches
the client to limit the intake of xanthine-containing foods while taking this
medication. These foods include coffee, cola, and chocolate.
Test-Taking Strategy: Focus on the subject, food items that need to be limited.
Recall that theophylline is a xanthine bronchodilator and that intake of excessive
amounts of foods naturally high in xanthines needs to be limited. Also, recalling that
these medications cause cardiac and central nervous system stimulation will direct
you to the correct option.
Level of Cognitive Ability: Applying
Client Needs: Physiological Integrity
Integrated Process: Teaching and Learning

1658